Bigger, cheaper prescription meds? Not so fast

Patients can cut costs in half by halving pills but must be careful, warn health-care professionals

Patients can cut costs in half by halving pills but must be careful, warn health-care professionals

July 25, 2005|by KRISTIN WILSON

Consumers can save money purchasing bulk quantities of dog food, diapers and dish detergent, health insurers and patients are wondering if bulk buys can translate to health care - whether bigger just might equal cheaper for prescription medications.

UnitedHealthcare, the second-largest U.S. health insurer, is experimenting with such a philosophy.

In June, the insurance company introduced a volunteer pilot program to find out if prescription medication patients in Wisconsin could save money by buying larger doses of pills and cutting them down to size.

Results are preliminary, but money is being saved by Veterans Affairs centers in the country, says Barbara Corbin, spokeswoman for the Martinsburg (W.Va.) VA Medical Center.


"I'm not exactly sure how much we save by using larger doses," she says. "But we can save up to half on some prescription costs."

Pharmacist Nelson Kline of the Boonsboro Pharmacy says that some drugs are "flat priced." That means regardless of the dosage, customers will pay about the same. When patients cut a strong dose into two it's almost a two-for-one savings, Corbin says.

But Kline cautions not all pills can be cut, and it isn't always possible to save with bigger pills.

"It depends on the medication," he says.

Sustained release pills or pills that come in capsule form do not work the same if they are severed, he explains.

Patient medications are controlled by physicians. In order to get larger doses for splitting, a doctor must write the prescription. Kline says doctors must be careful because not every patient should be splitting their own pills.

Dr. Rina Bansal of Hagerstown says she has not prescribed a large medication dose, directing a patient to cut pills on their own, but she does know that cutting costs for prescription drugs is always a concern.

"I've had a lot of patients come in complaining that they can't afford their medication," she says. "I haven't really come across pill-cutting, although I know it is done."

Debora Spano, spokeswoman for UnitedHealthcare, says the pill-cutting program in Wisconsin is one way her company is trying to reduce medical costs to patients.

"When people have affordable access to the medications they need, they are more likely to comply with their treatment plans," she says. "Better medication compliance means better outcomes and healthier people."

Corbin says the VA's pill-splitting program has been popular. "It's rare that we have a patient that's not interested in pill splitting," she says. But only 10 medications are part of the cost-saving program.

While there is concern that patients will not be able to split pills effectively or will forget to split altogether, there is greater concern that those on tight budgets already are cutting pills against the recommendations of doctors.

"We do hear it from patients who are coming in that they are cutting pills in half or skipping days," says Audrey Miller, a supervisor with the Western Maryland Medbank in Hagerstown. "People are skipping days because they cannot afford their medication."

Bansal, too, notes that patients hide what they do with their prescriptions from doctors.

"I've noticed you go over their medications and they've stopped prescriptions here and there because they can't afford it," she says.

Patients should never split a prescription drug unless advised to do so by their doctor, Bansal says. Especially for people who are on multiple medications, getting an abnormal amount of a particular drug could have serious side effects.

Cut costs without cutting pills

Interested in cutting prescription costs? Here are some things to try to trim costs:

  • Talk to your doctor about the possibility of getting large pills that can be cut in half. Many insurance companies offer incentives for getting the larger and sometimes cheaper doses.

  • Let your doctor know that prescription costs are a major factor for you. Sometimes there are less expensive or generic brands that can be prescribed.

  • Consider making some lifestyle changes. Dr. Rina Bansal reminds that sometimes there are things people can do to diminish their health problems and stay away from prescription medications altogether. "That's not easy to do, but at least it's something they can do to be proactive," she says.

Certain pills can be cut, if dosage is correct

Zoloft and Valtrex are two of the most commonly split pills among people trying to save money on prescription medications. UnitedHealthcare is recommending the following drugs for pill-splitting under their Wisconsin pilot program:

  • Aceon

  • Mavik

  • Atacand

  • Avapro

  • Benicar

  • Cozaar

  • Diovan

  • Lexapro

  • Pexeva

  • Crestor

  • Lipitor

  • Zocor

  • Pravachol
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